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Fri, 14 Jun 2002 14:50:31 BST

> We need to ensure those involved in training and service provision in
> surgery are aware of worldwide trends and approaches to the issues
> which is where trauma.org has huge relevance.
> 
> Whats the UK view? What about Europe? What happens in Asia, or South
> America.
Ian,
The UK has a limit on working time that is common throught the 
European Union (EU Working Time Directive). Our trainees are 
currently limited to an average 56 hours a week, in a complex system 
that also has limits of maximum duty periods (16 hours), minimum 
amount of rest between duty periods, maximum amount of work that 
can be at 'anti-social hours' (30%) etc. This maximum limit will go 
down to 48 hours a week from 1st December 2002. If a training post 
does not comply to these rules there is a large increase in salary 
(100% or more) for the trainee (making them earn more than me - but 
I'm not bitter!!!). The extra percentage is rising with time to make non-
compliant posts financially untenable for hospitals.

A new contract for consultants has just been announced in the UK 
around a 40 hour week (night time/weekend resident is included in the 
40 hours, night time/weekend 'on call' from home is in addition to 
40hrs).

If anything the training time is being shortened in the UK due to our 
urgent need for thousands of new doctors. (with proposals for the 
current 7 or 8 year postgraduate training being reduced to 5 or 6).

Shorter training and half or a third of the hours - difficult to see how 
high levels of technical expertise or experience will be accumulated. 
(See the Royal College of Surgeons of England website for a 
discussion of the severe problems that these issues bring up for 
surgical training).

Seems like a world-wide issue.

Tim.

Timothy J Coats MD FRCS FFAEM
Senior Lecturer in Accident and Emergency / Pre-Hospital Care
Royal London Hospital, UK.

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